Provider Demographics
NPI:1376660134
Name:COUNTY OF PLACER
Entity Type:Organization
Organization Name:COUNTY OF PLACER
Other - Org Name:PLACER COUNTY MENTAL HEALTH - SUNSET
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADULT SYSTEMS OF CARE
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-889-7256
Mailing Address - Street 1:1000 SUNSET BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3791
Mailing Address - Country:US
Mailing Address - Phone:916-784-6440
Mailing Address - Fax:
Practice Address - Street 1:1000 SUNSET BLVD
Practice Address - Street 2:STE 140
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765
Practice Address - Country:US
Practice Address - Phone:916-784-6440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF PLACER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3111OtherSTATE OF CA MENTAL HEALTH